Diabetes mellitus has become a growing health concern over the past two decades. In the years between 1980 and 2002. the number of people in the United States who have been diagnosed as having diabetes rose from 5.8 million to 13.3 million. Additionally, it was estimated by the Center of Disease Control (CDC) that there were 5.2 million unreported cases in 2002. thereby yielding a total of over 18 million Americans with diabetes.
Diabetes mellitus is a condition where the affected person has either a shortage or complete lack of insulin. This insulin insufficiency leads to high circulating levels of glucose and fatty acids in the blood. Increased blood glucose levels can cause many health problems which include heart disease, stroke, blindness, kidney failure, pregnancy complications, lower extremity amputations and peripheral neuropathy.
The resultant lack of sensation on the plantar aspect of the foot due to peripheral neuropathy often leads to the development of cutaneous ulcerations on the foot. Diabetic foot ulcerations are a serious medical concern. They have been shown to cause substantial emotional, physical, productivity and financial losses. The most costly and feared consequence of a foot ulcer is limb amputation, which occurs 10 to 30 times more often in patients with diabetes than the general population.
An important observation to note is that while the incidence of diabetes mellitus has been increasing in the United States, so has the rate of obesity. Many researchers and epidemiologists believe that insulin resistance (leading to diabetes mellitus type 2), obesity (especially in the abdomen), dyslipidemia, and hypertension have a common underlying cause given that they often occur together as the “Deadly Quartet.”
Leading a sedentary lifestyle is a major contributor to obesity. In addition to reducing obesity, an increase in physical activity may help heal diabetic foot ulcers. Physical activity increases angiogenesis, a necessary process for healing that is stunted in persons with diabetes. The activation in muscles also increases tissue temperature. Increasing tissue temperature through exercise may yield similar benefits as thermotherapy, a proven method for helping wounds to heal.
Besides helping to heal existing diabetic foot ulcers, exercise may help prevent future occurrences. Exercise physiologists and the CDC have documented the effects of physical activity and exercise on hypertension, blood glucose and dyslipidemia. The overall conclusion is that regular exercise (as defined by the American College of Sports Medicine) results in similar trends in blood pressure, heart rate, blood lipid levels and resting blood glucose levels. Decreasing blood glucose levels in persons with diabetic foot ulcers may delay the progression of neuropathy which may in turn decrease the incidence of future ulceration.